Journal of Orthopaedic Science最新文献

{"title":"Clinical characteristics and outcomes of proximal clavicle fractures: A retrospective cohort study from a single Japanese institution.","authors":"Shoichiro Hamada, Mikio Nakajima, Sumire Suzuki, Takuma Sasaki, Richard H Kaszynski, Makoto Hodohara, Kenichi Kawano, Yasuhito Tajiri","doi":"10.1016/j.jos.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.002","url":null,"abstract":"<p><strong>Background: </strong>Clavicle fractures are common injuries, with proximal clavicle fractures being relatively rare. Previous studies have suggested that proximal clavicle fractures are often associated with high-energy trauma and carry a high risk of complications. However, no studies have comprehensively described their clinical characteristics and severity in Japan. This study aimed to evaluate the clinical characteristics of proximal clavicle fractures and their association with injury severity compared to non-proximal clavicle fractures in Japan.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single community hospital. Patients diagnosed with acute clavicle fractures between April 2013 and March 2023 were included, excluding those presenting with cardiac arrest on arrival or more than 7 days post-injury. Patients were categorized into the proximal group (Robinson classification type 1) and the control group (other types). Data on age, sex, injury mechanism, fracture type, and concomitant injuries were analyzed. The association between fracture type and severity, defined as AIS ≥3 or ISS ≥16, was assessed using multivariate logistic regression.</p><p><strong>Results: </strong>A total of 361 patients (proximal group 30 vs. control group 331) were included. Patients in the proximal group were significantly older and had a higher proportion of injuries resulting from falls from standing height compared to the control group. There were no significant differences between the groups in the prevalence of severe concomitant injuries (AIS ≥3; 30 % vs. 19 %), major trauma (ISS ≥16; 10 % vs. 11.8 %), or in-hospital mortality. Logistic regression analysis revealed no significant association between proximal clavicle fractures and severe outcomes.</p><p><strong>Conclusions: </strong>This study focused on acute clavicle fractures tipically encountered in routine orthopediac practice in Japan. Proximal clavicle fractures were more common in older adults and were frequently caused by low-energy falls. Proximal clavicle fractures were not significantly associated with severe concomitant injuries or trauma.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced anatomical accuracy in arthroscopic all-inside lateral ligament repair using ultrasound-guided anchor placement.","authors":"Younguk Park, DaeHyun Han, Myungsub Lee, Young Wook Seo","doi":"10.1016/j.jos.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.015","url":null,"abstract":"<p><strong>Background: </strong>With significant advancements in arthroscopic surgical techniques, the frequency of arthroscopic lateral ankle ligament repair procedures has increased. However, anchor positioning accuracy remains uncertain, with studies suggesting a higher probability of the anchor being fixed in non-anatomical positions, such as insertion proximal to the fibular obscure tubercle (FOT). Using ultrasound guidance, anchors can be positioned more anatomically. This study aimed to analyze anchor position in arthroscopic all-inside lateral ligament repair using ultrasound.</p><p><strong>Methods: </strong>Thirty-three patients with chronic ankle instability were prospectively enrolled and underwent ultrasound-guided, arthroscopic all-inside lateral ankle ligament repair, termed Arthroscopic Ultrasound-Assisted All-Inside Repair of the Lateral Ankle Ligament (AURA). Postoperative computed tomography (CT) scans were taken to analyze anchor positions, with the FOT as the reference point. Subsequently, the anchor positions were classified as anatomic, sub-anatomic, and nonanatomic based on the relationship between the fibular anterior tubercle and the FOT.</p><p><strong>Results: </strong>The mean distance between anchor position and the fibular obscure tubercle (FOT) was 2.08 mm (range, 0-12 mm). Based on postoperative CT analysis, anchor placements were classified relative to the FOT: 28 of 33 cases (84.8 %) were within 25 % of the fibular length distal to the FOT (anatomic zone), 4 cases (12.2 %) were positioned between 25-50 % (sub-anatomic zone), and 1 case (3.0 %) was beyond 50 % (non-anatomic zone).</p><p><strong>Conclusion: </strong>The ultrasound-assisted technique demonstrated high anatomical accuracy in anchor placement, as confirmed by postoperative 3D-CT evaluation.</p><p><strong>Level of evidence: </strong>IV, case study.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of percutaneous intramedullary headless screw fixation with an oblique technique for the treatment of proximal and middle phalanx fractures.","authors":"Hiroki Yokoyama, Kenichi Asano, Hidemasa Yoneda, Katsuyuki Iwatsuki, Marie Mabuchi, Michiro Yamamoto","doi":"10.1016/j.jos.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.017","url":null,"abstract":"<p><strong>Background: </strong>Intramedullary headless screw fixation has become significant in the treatment of phalangeal fractures. While intramedullary headless screw fixation is a simple and rigid approach, common techniques for guide wire insertion, including retrograde, antegrade-intra-articular, and trans-articular techniques, damage the articular cartilage and extensor tendon, particularly the central slip. To mitigate these risks, we applied a new method by percutaneously inserting the screw obliquely from the radial or ulnar base of the proximal or middle phalanges. This study aimed to assess the clinical outcomes of intramedullary headless screw fixation using the oblique technique in the treatment of proximal and middle phalangeal fractures.</p><p><strong>Methods: </strong>Between April 2022 and August 2023, we retrospectively collected data on consecutive unstable proximal or middle phalangeal fractures treated with percutaneous intramedullary headless screw fixation using the oblique technique. The clinical outcomes were the active range of motion of each phalangeal joint and the grip strength ratio. Surgical time, fracture union, and complications were also evaluated.</p><p><strong>Results: </strong>Sixteen patients (6 middle and 10 proximal phalanx fractures) were included in this study. The mean operative time was 34.2 min, while the median fracture union time was 7.2 weeks. The mean values of the active range of motion (ROM) of extension and flexion of the proximal interphalangeal joint were -1.3° and 98.5°, respectively, in middle phalanx fractures and -9.2° and 83.7° in proximal phalanx fractures. No complications were observed.</p><p><strong>Conclusions: </strong>This study demonstrated the good clinical outcome of percutaneous intramedullary headless screw fixation using the oblique technique for proximal and middle phalangeal fractures. This simple technique reduces the damage risk to the articular cartilage and extensor tendons.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between lifestyle differences and sarcopenia, muscle mass in patients with rheumatoid arthritis: Comparison of metropolitan and country areas.","authors":"Masahiro Tada, Chika Yoshimura, Yoshinari Matsumoto, Koji Mandai","doi":"10.1016/j.jos.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.jos.2025.07.003","url":null,"abstract":"<p><strong>Objectives: </strong>Differences in living environments and lifestyle affect physical activity and the sarcopenia rate in rheumatoid arthritis (RA) patients. This study aimed to investigate the effects of differences in living environment and lifestyle by area of residence on the prevalence rate of sarcopenia, physical activity, and body composition in RA patients.</p><p><strong>Methods: </strong>Patients were divided into metropolitan (n = 77) and country (n = 67) groups by area of residence. Both groups were age- and sex-matched. Body composition was evaluated by a body composition analyzer, and the prevalence of sarcopenia was compared. Physical activity was assessed using the international physical activity questionnaire. Questions regarding means of commuting to hospital, family structure, and occupation type were asked to evaluate living environment and lifestyle. Associations between sarcopenia and lifestyle were investigated by univariate and multivariate analyses.</p><p><strong>Results: </strong>There was no significant difference in the prevalence of sarcopenia between the metropolitan (26.0 %) and country (34.3 %) groups. Muscle mass was significantly higher in the metropolitan group (34.6 kg) than in the country group (32.9 kg; p = 0.026). Transportation physical activity was significantly higher in the metropolitan group (693 METs⋅Min/Week) than in the country group (0 METs⋅Min/Week; p < 0.001). Multivariate logistic regression analysis, adjusted for age, disease duration, DAS28-ESR,mHAQ, and glucocorticoid usage, identified only unemployment as an independent factor associated with sarcopenia (OR: 3.40, 95%CI: 1.10-10.4, p = 0.032).</p><p><strong>Conclusions: </strong>RA patients living in metropolitan areas had significantly higher muscle mass than those living in the countryside. However, there was no significant difference in the prevalence of sarcopenia. Unemployment was identified as an independent factor associated with sarcopenia.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteosynthesis using ultra-high molecular weight polyethylene fiber cables for periprosthetic femoral fracture.","authors":"Shohei Sogawa, Kenichi Oe, Tomohisa Nakamura, Yosuke Otsuki, Takashi Toyoda, Fumito Kobayashi, Hirokazu Iida, Takanori Saito","doi":"10.1016/j.jos.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.018","url":null,"abstract":"<p><strong>Background: </strong>An ultra-high molecular weight polyethylene (UHMWPE) fiber cable, formed into a soft flexible tape, offers excellent properties for use in osteosynthesis. The purpose of this study was to evaluate the outcomes of osteosynthesis using the UHMWPE fiber cable.</p><p><strong>Methods: </strong>In this study, 23 patients who underwent osteosynthesis with the use of a UHMWPE fiber cable for periprosthetic fracture (PPF) following total or bipolar hip arthroplasty, at a total of 56 sites, were retrospectively evaluated. The procedures were performed between August 2010 and December 2022. The mean duration of clinical follow-up was 4.1 years (range, 1-10). The cable was used in two ways: direct cerclage around the femur at 38 sites and indirect cerclage around the femur through contact with a metal plate and/or strut grafts at 18 sites.</p><p><strong>Results: </strong>No clinical complications were observed after the use of UHMWPE fiber cables. Fracture union was confirmed in all cases, with a mean duration of 7.6 months (range, 2-21). Local bone atrophy was observed in 27 % (15/56 sites), with a mean occurrence of 0.9 years (range, 0.1-2.9), but this atrophy did not progress. Significantly less bone atrophy was noted at the greater trochanter than at the femoral shaft (P = 0.009). The atrophy incidence rate was 39 % (15/38 sites) for direct cerclage and 0 % for indirect cerclage (P = 0.0009).</p><p><strong>Conclusion: </strong>Osteosynthesis using a UHMWPE fiber cable for PPFs yielded successful results and was especially useful for reduction and fixation around the greater trochanter. However, for direct cerclage at the femoral shaft, particular attention to strategies that can prevent local bone atrophy is required.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application effect of vacuum sealing drainage combined with nano-silver dressings in the treatment of non-healing wounds after surgery for open limb fractures.","authors":"Taihua Huang, Haiping Huang","doi":"10.1016/j.jos.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.012","url":null,"abstract":"<p><strong>Background: </strong>Non-healing wounds after open limb fracture surgery pose clinical challenges, requiring effective management; vacuum sealing drainage (VSD) promotes healing by removing exudate and stimulating granulation, while nano-silver dressings provide antimicrobial protection to reduce infection risk. We aimed to probe the application effect of VSD combined with nano-silver dressings in the treatment of non-healing wounds after surgery for Gustilo type III open limb fractures.</p><p><strong>Methods: </strong>A total of 60 patients with non-healing wounds after surgery for Gustilo type III open limb fractures were randomly divided into two groups, with 30 cases in each group. The control group received conventional therapy, and the study group received VSD combined with nano-silver dressings. Before treatment and after 7 days of treatment, inflammatory cytokines (C-reactive protein (CRP) and procalcitonin (PCT)) in serum and growth factors (transforming growth factor beta1 (TGF-β1) and vascular endothelial growth factor (VEGF)) in wound exudate were measured using enzyme-linked immunosorbent assay. The pain level of the patients was measured by the Visual Analogue Scale (VAS). Patients' skin quality was assessed by the Vancouver Scar Scale (VSS), and the efficacy of trauma treatment was observed in both groups.</p><p><strong>Results: </strong>After 7-day treatment, the study group performed lower levels of CRP and PCT, higher levels of TGF-β1 and VEGF, lower VAS scores and VSS scores, and better overall treatment rate compared to the control group (all P < 0.05).</p><p><strong>Conclusion: </strong>VSD combined with nano-silver dressings has good therapeutic efficacy in non-healing wounds after surgery for open limb fractures and can inhibit inflammatory response and improve skin quality.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercalary autograft not mandatory for shortening in total hip arthroplasty: A retrospective study.","authors":"Mehmet Fevzi Cakmak, Serkan Bayram, Levent Horoz, Hicabi Sezgin, Burak Akan","doi":"10.1016/j.jos.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the clinical and radiological outcomes of patients who underwent autograft application following standard transverse osteotomy supported by two cobalt-chrome cables with those who did not use autografts to support the osteotomy line in Crowe type IV Developmental Dysplasia of the Hip (DDH).</p><p><strong>Methods: </strong>Sixty-nine patients (78 hips) with Crowe type IV DDH underwent a transverse subtrochanteric shortening osteotomy. In Group 1, 42 hips had their osteotomy site supported with an autograft harvested from the shortening osteotomy. Conversely, Group 2 consisted of 36 hips in which graft application was not performed, and fixation of the osteotomy site was solely achieved by employing the femoral stem. Clinical outcome measures included limb length discrepancy, pain (visual analog score), and functional Harris Hip Score (HHS). For radiological evaluation, bone healing of the femoral osteotomy site was assessed using the radiographic union score for tibial (mRUST) classification, and stabilization of components was evaluated according to the Engh classification.</p><p><strong>Results: </strong>There were no significant differences in age, body mass index, follow-up duration, preoperative and postoperative LLD, VAS score, and HHS values. No statistically significant difference was identified between the Engh classification. Significant differences between the groups were detected in the mRUST classification (p = 0.020). The mean value of the group not utilizing autograft (11,89 ± 1,83) was higher than that of the group using autografts (10,95 ± 1,59). There was no statistically significant relationship between complications between the groups (p = 0.981).</p><p><strong>Conclusion: </strong>Performing of THA in Crowe type IV DDH, the press-fit application of the femoral component, without additional implantation or grafting, have shown comparable and satisfactory outcomes.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical study of ten-year prognosis in patients with lumbar disc herniation treated with condoliase in a phase III trial.","authors":"Yukihiro Matsuyama, Tomohiro Banno, Hideaki Imabayashi, Tetsuro Takatsu, Fumihiro Oha, Takashi Tsuji, Tetsuya Watanabe, Masaki Tatsumura, Kyohei Sakaki, Yoji Ogura, Yoshihisa Suzuki, Tetsuya Ohara, Tadashi Komatsubara, Takahiko Hyakumachi, Masahiro Hoshino, Yoshio Sakuma, Kozo Chino, Kei Ando, Kiyotaka Yamada, Ippei Watanabe, Miwako Sato, Taiichi Shirogane, Kazuhiro Chiba","doi":"10.1016/j.jos.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Condoliase is a chemonucleolytic agent approved in Japan for the treatment of lumbar disc herniation (LDH). There had been no follow-up evaluation of its long-term effects on discs covering a period exceeding 10 years.</p><p><strong>Methods: </strong>The present study evaluated the 10-year post-dose outcomes of patients treated with condoliase during the phase III trial in terms of neurological results, Oswestry Disability Index (ODI), X-ray findings (disc height, posterior intervertebral angle, vertebral body translation), and magnetic resonance image findings (Modic classification, Pfirrmann grade).</p><p><strong>Results: </strong>Among the 82 patients treated with condoliase during the phase III trial, 37 (45.1 %) were available for the 10-year post-dose follow-up in the present study. At 10 years post-dose, low back pain and leg pain were observed in 15 (40.5 %) and 6 (16.2 %) of 37 patients, and the number of patients with positive straight leg raise test, hypesthesia, muscle weakness, and deep tendon hyporeflexia were 1 (2.7 %), 2 (5.4 %), 0 (0 %), and 8 (21.6 %), respectively; mean ODI was 8.6, with 32/37 (86.5 %) patients having ODI of 0 %-20 %; 8 (21.6 %) patients had disc height decreased by ≥ 30 %; 1 patient had posterior intervertebral angle of ≥5° and 1 had vertebral body translation of ≥3 mm. Although 5 patients (13.5 %) underwent lumbar surgery after receiving condoliase, no patient underwent surgery for spinal instability. In the Modic classification, the number of patients with \"Type 0,\" \"Type 1,\" and \"Type 3\" decreased, while those with \"Type 2\" increased compared to evaluations conducted at 1-year post-dose. For Pfirrmann grade, the number of patients with \"Grade IV\" decreased and those with \"Grade V″ increased from 1 to 10 years post-dose.</p><p><strong>Conclusions: </strong>No significant imaging findings necessitating surgery were observed, suggesting that chemonucleolysis with condoliase remains a safe and effective treatment option for LDH over the long term.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the upper line of the sacral ala approximate a horizontal line on pelvic radiographs of idiopathic scoliosis?","authors":"Masaki Ikejiri, Hideki Shigematsu, Sachiko Kawasaki, Yuma Suga, Takahiro Mui, Yasuhito Tanaka","doi":"10.1016/j.jos.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.009","url":null,"abstract":"<p><strong>Background: </strong>Lower instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) corrective surgery is selected using the center sacral vertical line on supine side-bending radiographs. However, a horizontal line reference is not possible on supine radiographs. Therefore, we aimed to determine the pelvic reference line that best reflects the horizontal line, which can be used in determining the LIV on supine side-bending radiograph in patients with AIS.</p><p><strong>Methods: </strong>Patients with AIS (n = 258) were evaluated. On whole-spine standing anteroposterior radiographs, three lines were selected (the upper sacral line [USL], sacroiliac joint line [SIL], and upper iliac line [UIL]) and compared with the horizontal line to investigate tilt angles. Patients were allocated into thoracic (T; n = 90), lumbar (L; n = 61), and double (D; n = 107) curve groups based on thoracic and lumbar Cobb angles.</p><p><strong>Results: </strong>The mean USL; SIL; and UIL tilts were 2.3°, 4.7°, and 3.8°; 1.6°, 2.0°, and 2.0°; and 1.4°, 2.2°, and 1.8° in the T, L, and D groups, respectively. The USL was significantly tilted in all groups, without significant difference between the SIL and UIL tilts. The USL tilted significantly more from the horizontal line in the L and D groups than in the T group; the UIL tilted more in the L group compared with the T group. The SIL tilt was comparable between the groups. The Cobb angle on the thoracolumbar or lumbar curve significantly, albeit weakly, correlated with the USL and UIL tilt.</p><p><strong>Conclusions: </strong>On whole-spine standing anteroposterior radiographs, the USL had the greatest tilt (mean: 3.5°), whereas the SIL had the smallest tilt (mean: 1.8°) without significant variation across scoliosis types. Independent of Cobb angle and scoliosis type, the SIL was the most stable and reliable reference line for horizontal alignment, making it the preferred reference to LIV selection in patients undergoing AIS corrective surgery.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of decompression surgery and erythropoietin combination on a rat model of compressive myelopathy.","authors":"Yuki Shiratani, Takeo Furuya, Yuki Nagashima, Yasunori Toki, Masataka Miura, Sho Okimatsu, Juntaro Maruyama, Kyota Kitagawa, Takaki Inoue, Atsushi Yunde, Satoshi Maki, Seiji Ohtori","doi":"10.1016/j.jos.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.013","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spondylotic myelopathy (CSM) is a degenerative condition caused by spinal cord compression, leading to significant neurological impairments. While decompression surgery is the gold standard for treating CSM, recovery is often incomplete, prompting the need for adjunct therapies. Erythropoietin (EPO), widely used for anemia treatment, has shown beneficial effects on the nervous system. This study evaluates the combined effects of decompression surgery and EPO administration in a rat model of compressive myelopathy.</p><p><strong>Methods: </strong>We developed a rat model of compressive myelopathy using a gradually expanding polymer sheet at C4-C5 levels. Rats were divided into three groups: Control (sham surgery, weekly saline injections), Decompression (decompression surgery, weekly saline injections), and Decompression + EPO (decompression surgery, weekly EPO injections). Motor function, myelination, and axonal integrity were evaluated over eight weeks using Basso, Beattie, and Bresnahan (BBB) scores, grid runway tests, and histological analyses.</p><p><strong>Results: </strong>The decompression + EPO group exhibited significantly better motor function, with higher BBB scores and fewer hindlimb drops in grid runway tests compared to the Control group. Histological analyses revealed enhanced myelination in the corticospinal tract, as shown by Luxol Fast Blue (LFB) staining and myelin basic protein (MBP) staining, along with increased axonal growth marked by growth-associated protein 43 (GAP-43) expression.</p><p><strong>Conclusion: </strong>Combining decompression surgery with EPO administration significantly improved motor recovery and promoted spinal cord myelination in a rat model of compressive myelopathy. These findings suggest EPO as a promising adjunct to surgical treatment in CSM, warranting further clinical investigation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}